Insure Oh Sure

I spent a good hour on the phone with my old health insurance company today. Good thing I fight these people for a living and can afford to spend the time it takes to deal with them. I bet they make so much money off of people who just chuck in the towel and pay up to avoid the hassle. If I weren't in this line of work, I probably would too.

It all started when I got a call from a collections agency last night. Turns out I owe Quest Diagnostics some money. However, I don't remember ever getting a bill or a warning or really anything that even resembled a notice that - if ignored - might turn into a call from a collections agency.

So I typed in the url left on my voicemail, and sure enough, Quest had my old address. From more than a year ago. So if they've been sending bills, they haven't been sending them to me.

So my first call was to the collections agency followed by a call to the doctor on the claim. My next call was to the insurance company. The call after that was to another department of the insurance company. Then another call to the doctor's office. A call to the astonishingly unhelpful people at Quest. And then one last call back to my doctor's office where the office administrator - LOVE HER - offered to call Quest herself and set them straight.

But the reason I had to waste so much time on the phone with the insurance company in the midst of all this is because the bill was for blood work they refused to cover. According to "Brian" who was combative and defensive, I'm only allowed blood work once every two years. In fact, Brian explained, I may have had the plan that only allows physicals once every two years.

Really?

That sound like a strategy that's best for the patient's health or a short-sighted, cost-saving policy implemented to maximize a health insurance company's profits?

I'm going with door #2.

Turns out when they do this particular blood work, if something comes out a little off, the lab does more blood work to figure out what's going on. That's the test they allegedly coded inaccurately - the follow-up - and the insurance company's refusing to cover. But as the office administrator at the doctor's office told me today, the lab has to do the follow-up. If they didn't, and g-d forbid something happened to the patient, the lab and the doctor would be liable.

It's a dangerous game the insurance companies play when they refuse to cover health care people need. And the fact that they're willing to play it for pay is all you need to keep in mind when you hear they're "on your side" and "all for reform" this time around.